Compressive Trigeminal Neuropathy after Caldwell-Luc Operation

Most postoperative maxillary cysts develop more than 10 years after a Caldwell-Luc operation. They can manifest with cheek pain, swelling and dental and visual symptoms. Brain imaging should be performed to distinguish trigeminal nerve compression from various other possible causes. It should be treated by surgical intervention to relieve the above-mentioned symptoms. We report a patient who presented with compressive trigeminal neuropathy caused by a postoperative maxillary cyst.

Compressive Trigeminal Neuropathy after Caldwell-Luc Operation

Most postoperative maxillary cysts develop more than 10 years after a Caldwell-Luc operation. They can manifest with cheek pain, swelling and dental and visual symptoms. Brain imaging should be performed to distinguish trigeminal nerve compression from various other possible causes. It should be treated by surgical intervention to relieve the above-mentioned symptoms. We report a patient who presented with compressive trigeminal neuropathy caused by a postoperative maxillary cyst.

A Case of Ectopic Tooth in the Maxillary Sinus Associated with a Mucocele / 대한이비인후과학회지

Supernumerary, ectopic tooth eruption in a non-dental area is a rare entity. The ectopic development of tooth found in non-dental environment has been reported in places such as the nasal cavity, chin, maxillary sinus, mandibular bone, palate and orbital cavity. Ectopic tooth eruptions in the maxillary sinus are usually asymptomatic and are found incidentally during routine clinical or radiological investigations. The diagnosis is usually made by plain-film radiography. Computed tomography is indicated when an ectopic tooth is found prior to surgery. Standard treatment for an ectopic tooth is extraction of the tooth. Here, the authors present a case of supernumerary, ectopic tooth found in the maxillary sinus associated with a mucocele.

Maxillary Sinus Mucocele as a Late Complication in a Patient Underwent Lefort I Procedure

PURPOSE: The authors report unusual one case of a patient presenting with maxillary sinus mucocele who had underwent Lefort I procedure 7 years ago. METHODS: Case report and literature review RESULTS: A 25 year old man came to us with fullness, pain and nasal obstruction on his left cheek area. He had a history of multiple operations due to cleft lip and palate since birth. Two jaw surgery was performed for correcting class III malocclusion 7 years ago. Computed tomography showed haziness, and fluid filled cystic mass on left maxillary sinus. Nasoendoscopy revealed the bulging of inferior turbinate and mucosa coincided in medial wall of maxillary sinus. Antrostomy with Caldwell-Luc approach was performed. Mucin contaning brownish exudate was leaked out. Severe inflammation of maxillary inner wall and exposure of 2 screws fixed previously were noticed. The curettage and marsupialization were accomplished. The symptoms of patient were improved after that procedure. CONCLUSION: Maxillary sinus mucocele is related with Lefort I procedure and it may occur even long after that procedure.

Long-Term Outcomes of Transnasal Endoscopic Marsupialization through Middle, Inferior Meatal Antrostomy or Extended Middle Meatal Antrostomy in Maxillary Sinus Mucoceles

Backgroud and Objectives: There are few reports about long-term outcomes of transnasal endoscopic marsupialization of isolated maxillary sinus mucocele. The approach routes of endoscopic marsupialization in those papers were mainly through middle meatal antrostomy. However, it is difficult or impossible to treat maxillary sinus mucocele by transnasal endoscopic middle meatal antrostomy in some cases. The aim of this study was to investigate long-term outcomes of transnasal endoscopic marsupialization according to three different approach routes. Materials and Methods: We reviewed 20 consecutive patients underwent transnasal endoscopic marsupialization and followed up for at least 66 months, retrospectively. Ten patients were treated by transnasal endoscopic middle meatal antrostomy with marsupialization, four by inferior meatal antrostomy and six by extended middle meatal antrostomy. RESULTS: No evidence of recurrence and major complications were observed during follow-up periods ranging from 66 to 102 months (mean, 80 months) according to three different approach routes. CONCLUSION: Transnasal endoscopic marsupialization with the appropriate antrostomy route according to the location and bulging direction of maxillary sinus mucoceles is considered to be an effective therapeutic method with favorable long-term outcomes

Prolapsed Antral Mucosa: Variant of Maxillary Sinus Mucocele / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An array of diseases may cause masses in the maxillary sinus. Among the various diseases, the prolapsed antral mucosa (PAM) presents an inflammed, swollen maxillary antral mucosa which becomes redundant and prolapsed into the nasal cavity through a widened natural ostium, mimicking an antrochoanal polyp. The purposes of this study were to introduce prolapsed antral mucosa and evaluate the differences between prolapsed antral mucosa and other diseases, particularly maxillary sinus mucocele. MATERIALS AND METHODS: We retrospectively analyzed 18 patients who were diagnosed with prolapsed antral mucosa at the Kangbuk Samsung Hospital between 1990 and 1998. The presenting signs and symptoms, endoscopic finding, radiological finding, histopathological finding were reviewed. RESULTS: Of the symptoms reported by patients in this study, nasal obstruction was the most frequent, followed by rhinorrhea, postnasal drip, foul odor and headache. Endoscopic findings showed protruding maxitlary antral mucosa into the middle meatus. On the CT, the prolapsed antral mucosa presented features such similar to antrochoanal polyp as unilateral and homogeneous soft tissue density which extended into the middle meatus. MR imaging was useful for differentiating the prolapsed antral mucosa from neoplasms and antrochoanal polyp. Prolapsed antral mucosa and maxilla sinus mucocele showed the same histopathological features such as epithelial lining of columnar or metaplastic squamous cells with varying glandular structures, and dense fibrous stroma intiltrated by infiammatory cells. CONCLUSIONS: The prolapsed antral mucosa is considered as a variant of maxillary sinus mucocele. History, physical examination, biopsy, CT and MM are useful for differentiating the prolapsed antral mucosa from other diseases. Although a prolapsed antral mucosa is rare, it should be considered in the diagnosis and the treatment of unilateral maxillary sinus lesion.